Dynamic history of low-grade gliomas before and after temozolomide treatment
| Autor: | Khê Hoang-Xuan, Jean-Yves Delattre, S. Taillibert, Julie Lejeune, Damien Ricard, Alexandra Amiel-Benouaich, Yannick Marie, Gentian Kaloshi, Rémy Guillevin, Michèle Kujas, Marc Sanson, Florence Laigle-Donadey, Emmanuel Mandonnet, Karima Mokhtari, Philippe Cornu, Antoine F. Carpentier, Laurent Capelle, Hugues Duffau, Antonio Omuro |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Drug resistance Chromosomes Central nervous system disease Internal medicine Glioma Temozolomide medicine Humans Neoplasm Antineoplastic Agents Alkylating Molecular Biology Aged Tumor size medicine.diagnostic_test Brain Neoplasms business.industry Magnetic resonance imaging DNA Neoplasm Middle Aged Genes p53 medicine.disease Magnetic Resonance Imaging Surgery Dacarbazine Neurology Drug Resistance Neoplasm Tumor progression Female Neurology (clinical) business Algorithms Follow-Up Studies medicine.drug |
| Zdroj: | Annals of Neurology. 61:484-490 |
| ISSN: | 1531-8249 0364-5134 |
| DOI: | 10.1002/ana.21125 |
| Popis: | Objective To evaluate the natural progression and the impact of temozolomide in low-grade gliomas and to correlate these changes with the profile of genetic alterations. Methods The mean tumor diameter (MTD) of low-grade gliomas was evaluated on serial magnetic resonance images before (n = 39), during, and after (n = 107) treatment with neoadjuvant temozolomide. MTD growth curves were correlated with chromosomes 1p-19q loss and p53 overexpression in the tumors. Results Before temozolomide onset, MTD increased linearly over time, indicating a continuous growth that was significantly slower in 1p-19q deleted tumors (3.4 vs 5.9mm/year; p = 0.0016) and in tumors that did not overexpress p53 (4.2 vs 6.3mm/year; p = 0.05). During temozolomide treatment, almost all patients (92%) experienced initial decrease of MTD. Subsequently, some tumors started to resume growth despite continuous administration of temozolomide, with a lower rate of relapse in 1p-19q deleted tumors (16.6 vs 58%; p = 0.0004) and in tumors that did not overexpress p53 (26 vs 68%; p = 0.003). When temozolomide was discontinued in the absence of tumor progression, a majority of tumors resumed their progressive growth within a year. Interpretation Untreated low-grade gliomas grow continuously at a rate that is influenced by the genetic alterations of the tumors. Temozolomide reverses this pattern at the onset, but this effect is often brief in patients whose tumors overexpress p53 and do not harbor the 1p-19q codeletion, suggesting acquired chemoresistance. A majority of tumors will resume their growth when treatment is discontinued, raising the issue of the optimal duration of treatment in continuously responding patients. Ann Neurol 2007;61:484–490 |
| Databáze: | OpenAIRE |
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